A Hernia is a weakness or tear in the abdominal muscle wall, which usually holds the inner lining of the abdomen and internal organs in place. The weakness or tear allows the inner lining to produce and form a pouch. The bulge a patient may see is normally a loop of intestine protruding through the tear in the muscle and into that pouch. Most hernias occur in the abdominal area, in between your chest and hip bones. Hernias that can be pushed back into place are called reducible hernias. Those that cannot be popped back into position are termed irreducible or incarcerated.
If you can feel the hernia on the outside of your body (as you might also notice a bump), you have an external hernia. However, if you cannot feel the hernia, it is known as an internal hernia. There are several other types of hernia. The most common include:
- Inguinal hernia – This is the most common type of hernia. An inguinal hernia occurs whenever a tissue or part of your small intestine pushes into your groin or scrotum, causing a visible bulge. Inguinal hernias are much more common in men rather than women. You can either be born with an inguinal hernia, or it can develop over time.
- Indirect inguinal hernia – An indirect hernia follows the pathway that the testicles made during fetal development, descending from the abdomen into the scrotum. This pathway usually closes before birth although may remain a possible site for a hernia in later life. Sometimes the hernia sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age.
- Direct inguinal hernia – The direct inguinal hernia occurs slightly to the inside of the site of an indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum and can cause pain that is difficult to distinguish from testicle pain. Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because abdominal walls weaken as they age.
- Femoral hernia – A femoral hernia occurs when fatty tissue or part of the intestine pushes through the groin.
- Umbilical hernia – An umbilical hernia happens when fatty tissue or part of the intestine protrudes through the abdomen near the belly button. Umbilical hernias are most common in infants, especially those who are premature or have a low birth weight, but adults can get them as well. A protruding belly button or soft swelling or bulge near the navel are signs of an umbilical hernia.
- Hiatal hernia – A hiatal hernia occurs when part of the stomach pushes through an opening in the diaphragm and up into the chest cavity. Symptoms of a hiatal hernia include heartburn, indigestion, having a difficult time swallowing, and chest pain.
- Incisional hernia – An incisional hernia occurs when tissue pushes through a scar from an abdominal or pelvic operation.
Causes & Symptoms
Some hernias do not cause any symptoms. When they do cause symptoms, however, they are typically related to the surrounding organs and structures. For instance, hernias in the abdomen can cause acid reflux, constipation, or abdominal pain. Hernias involving the diaphragm can cause shortness of breath and chest pain. Hernias in the groin can cause pain in the testicles. 66% of patients with hernias in their groin have symptoms, most commonly pain that is worse if they cough, lift, exercise, or have a bowel movement. Oftentimes, the pain, swelling, and other symptoms will resolve on their own when a person lays down. The bulge from the hernia might be easier to see when someone is standing. Other symptoms linked to hernias include the following:
- Digestive issues like heartburn
The discomfort may be more intense when you strain or tighten your abdominal muscles.
Who Gets a Hernia?
Certain lifestyle habits, activities, and medical or health conditions might make you more likely to develop a hernia in your lifetime. Sometimes, a tendency to get hernias runs in families, meaning there could be a genetic component. A baby can also be born with a type of hernia that affects the diaphragm; this condition is thought to occur in about 1 in every 2,000 births and requires surgery.
Hernias can happen to anyone, either male or female, young or old. Some are born with a weakness to their muscle walls and other times it develops over the years. Some risk factors for hernia development include:
- Gender – Males are about twice as likely as females to have hernias, largely due to the male anatomy; when the testicles descend from the abdomen during fetal development, the opening does not always close properly, making a hernia, particularly an inguinal hernia, more likely at some point in life.
- Overweight or obese – Extra weight increases pressure on muscles and organs, weakening the structures that hold things in place.
- Pregnancy – As a fetus grows and develops, so too, does the strain on the abdominal wall of the pregnant person.
- Age – Muscles become weaker as people age.
- Surgery – Surgery in the abdominal or groin area may weaken the muscles.
- Activities that can strain abdominal muscles – Primarily people who constantly carry heavy objects.
- Coughing – Coughing places pressure on the chest and abdomen.
- Family history – Men with a family history of inguinal hernias are eight times more likely to develop one than men without a family history.
How Does It Affect You? How Serious Is It?
If you ever feel pain around the hernia that is sudden or severe, or you experience nausea and vomiting along with the pain, it is highly recommended to seek immediate medical attention. This could be a sign that an organ or tissue is dangerously stuck within the torn area or that its blood supply is being cut off.
A hernia is a hole in the abdomen or muscle, occurring when part of an internal organ protrudes through the wall of the muscle where it is contained. Usually, they occur in the abdomen and groin and present as bulges at the navel, abdomen, or along with scars from previous surgical procedures.
Other risk factors linked to hernia include diabetes, smoking, unhealthy body weight, and heavy lifting, as described below:
Some studies show that there is an increasing concern about the success of ventral and umbilical hernia repair in diabetic women. However, studies suggest diabetes increases the risk of complications following the repair of ventral or umbilical hernia surgery. Results of the studies indicated a higher rate of complications among those who were insulin-dependent.
If you smoke, you could be contributing to a potential hernia. Smokers and those with diseases caused by tobacco use are plagued by continued, violent coughing that can contribute to hernia development. Quitting will also help decrease the risk of all manner of cancer and other diseases.
Unhealthy body weight
Excessive body weight can put tremendous pressure on the abdominal wall, causing it to weaken over time. Being overweight may also increase the risk of a hernia. Whenever you stand or move, the walls surrounding the abdomen are constantly under pressure from excess body fat. Being overweight can also put more stress on other muscle groups during movement and exercise.
Whether you are an athlete or have a job that requires heavy lifting, you have a higher chance of an inguinal hernia every time you pick up something. Using proper lifting techniques can minimize the risk and decrease fatigue.
Recommended Treatment & Supporting Equipment
In order to diagnose an internal hernia, a thorough medical history and physical examination will likely be performed. Since internal hernias are not visible externally, they may require imaging studies in order to be visualized. CT scans are usually used to help diagnose an internal hernia, however, X-ray can also be used when a CT scan is unavailable. In some cases, a laparoscopy, which is a minimally invasive surgical procedure, may be required to determine the severity of the hernia. It is important to promptly diagnose hernias due to the increased risk of developing a small bowel obstruction, which refers to a blockage of the small intestine that can result in life-threatening complications if left untreated. In some cases, hernias can also result in other complications, such as the loss of blood supply to surrounding tissues or bladder compression.
Depending on size, location, and symptoms, a physician will decide to treat the hernia surgically or monitor it for changes until intervention becomes necessary. However, it is important to note that hernias do not resolve on their own and will grow in size and complexity over time. Your surgeon may recommend a minimally invasive, surgical repair. Recent advances like robotic surgery allow for reduced pain by combining minimal surgical access with the precision of open surgery. However, larger hernias will require more invasive surgery than newer, smaller hernias. Types of hernia surgery include open surgery and laparoscopic surgery, as described below:
Open surgery – In open surgery, the surgeon cuts through the body where the hernia is located. The bulging parts are put back into place and the tear is stitched. Instead of sutures, a doctor might use a mesh panel to provide support.
Laparoscopic surgery – Using small incisions through which surgical tools, the organs / tissues are moved back to where they belong, and the hole is repaired. This is considered minimally invasive surgery and has a quicker recovery time than open surgery.
After surgery, a patient may experience pain around the surgical site. A surgeon will prescribe medication to help ease this discomfort whilst he / she recovers. Following a hernia repair, one may be unable to move around normally for several weeks. Any strenuous activities may need to be avoided. Open surgery often requires a longer recovery process than laparoscopic surgery. Your surgeon will let you know when you can return to your normal routine. Ignoring symptoms can result in emergency surgery for obstruction or strangulation of the bowel. If you have a hiatal hernia, over-the-counter and prescription medications that reduce stomach acid can relieve your discomfort and improve symptoms. These include antacids and proton pump inhibitors.
Certain exercises that work to strengthen your abdominal muscles can help reduce your risk of getting an inguinal hernia. Other exercises can help you recover after hernia surgery. Here are a few exercises to help prevent and recover from a hernia:
Lie down on your back with your knees bent. Your feet should be planted on the surface, and your hands should be on your hips. Afterwards, take a deep breath through your nose. As you breathe out, pull your belly button in towards your back. Hold this position for several seconds. Finally, relax and breathe normally, then repeat the procedure 2-3 times.
Seated bicep curls
Sit down so that your back is resting against something, and your feet are firmly placed on the ground. Then, grab two lightweight dumbbells with your palms facing forwards, and let your arms hand to the side. Lower your shoulders and push your shoulders back. Afterwards, take a deep breath. While you breathe out, bend each elbow at the same time and bring the weights towards your chest. Be sure to keep your back straight and shoulders down, and do not overextend your wrists. Lastly, inhale and gently bring the weights back down to your starting position.
First, lie on your back on a mat. Then, bend your knees and keep them in an elevated position. Now using both legs, start the cycling motion. Once you feel the burn in the abdomen, stop the exercise.
Walk for 30 minutes
Walking for about 30 minutes a day will help strengthen your lower and upper abdomen.
Alternative & Homeopathic Treatment
While home remedies will not cure your hernia, there are some things that you can do to help with your symptoms, such as the following:
Aloe Vera has anti-inflammatory and soothing properties. It acts as a natural pain reliever when one is suffering from a hernia. For effective results, drink a glass of aloe vera juice. Aloe vera is also good for treating a hernia if it is consumed between meals. The liquid of aloe vera can also be applied to the affected part.
Taking short and light meals
Changes in diet are good for getting relief from hiatal hernia. This will not make the hernia go away, but it will reduce its severity.
In case of a hernia in the abdomen or groin, there can be redness, inflammation, and pain. And ice will help reduce it. Applying an ice pack on the affected area will reduce contraction, pain, and inflammation.
Yoga can always be helpful for preventing hernia but it should only be done if an individual can comfortably do the strenuous asanas, otherwise a professional’s advice must be sought before trying these poses. The asanas focus on strengthening abdominal muscles, compressing the inguinal canal, and relieve abdominal pressure.